ABO blood group frequency in Ischemic heart disease patients in

Open Access
Original Article
ABO blood group frequency in Ischemic
heart disease patients in Pakistani population
Saima Sharif1, Naureen Anwar2,
Tasnim Farasat3, Shagufta Naz4
ABSTRACT
Objectives: To determine if there is any significant association between ABO blood groups and ischemic
heart disease (IHD).
Methods: The study was performed at Punjab Institute of Cardiology (PIC), Lahore. Study duration was
from January 2012 to September 2012. This study included 200 IHD patients and 230 control individuals.
Self design questionnaire was used to collect information regarding risk factors. Standard agglutination
test was performed to determine the blood groups. Data was analyzed on SPSS 16.
Results: The prevalence of blood groups in IHD group was 34% in blood group A, 29% in blood group B,
14% in blood group AB and 23% in blood group O. In control group the distribution of B, A, AB and O blood
groups were 34.4%, 20.9%, 12.6%, 32.2% respectively. Rh+ve factor was prevalent in 90.5% among IHD group
and 92.6% in control subjects. The prevalence of IHD was more in males (63.5%) as compared to females
(36.5%). Mean age was 56.4±0.86 (yrs) and BMI was 26.4±0.33 (kg/m2). The prevalence of hypertension was
58.5%, diabetes was 53%, family history of cardiac disease was 45%, 35.5% of patients were doing exercise
regularly, 58.5% used ghee, and 58% were smokers.
Conclusion: Subjects with blood group A had significantly (p< 0.05) higher risk of developing IHD as compare
to other blood groups.
KEY WORDS: ABO blood group, Ischemic heart disease.
doi: http://dx.doi.org/10.12669/pjms.303.4502
How to cite this:
Sharif S, Anwar N, Farasat T, Naz S. ABO blood group frequency in Ischemic heart disease patients in Pakistani population. Pak J Med
Sci 2014;30(3):593-595. doi: http://dx.doi.org/10.12669/pjms.303.4502
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Dr. Saima Sharif,
Assistant Professor,
2. Naureen Anwar, MS student,
3. Tasnim Farasat,
Professor,
4. Dr. Shagufta Naz,
Assistant Professor,
1-4: Department of Zoology,
Lahore College for Women University,
Lahore, Pakistan.
Correspondence:
Naureen Anwar, MS student,
Department of Zoology,
Lahore College for Women University,
Lahore, Pakistan.
E-mail: [email protected]
*
*
*
*
Received for Publication:
October 19, 2013
Revision Received:
October 30, 2013
Second Revision Received:
January 30, 2014
Final Revision Accepted:
February 25, 2014
INTRODUCTION
IHD is one of the most critical problems of the
civilized world. Of the 16.7 million deaths from
CVDs every year, 7.2 million are due to IHD.1
During past years, many reports have appeared
showing association of blood groups to coronary
heart disease and IHD. Among different categories
of IHD, the frequencies of stable angina, acute
myocardial infarction, and stable angina were
higher in AB blood group.2 In UK population IHD
was found to be prevalent in AB blood group.3
Wazirali showed blood group A was 3.14 fold
more prevalent than blood group B, 6.35 fold than
blood group O, and 3.32 fold than blood group AB.4
Similarly blood group A was dominant in patients
in Rawalpindi.5
Pak J Med Sci 2014 Vol. 30 No. 3
www.pjms.com.pk 593
Saima Sharif et al.
Table-I: Frequency of risk factors in IHD group.
Sr. No Risk factors
1
2
3
4
5
6
Smoking
Family history
Diabetes
Hypertension
Exercise
Use of ghee
Yes
No
108 (54%)
90 (45%)
107 (53.5%)
117 (58.5%)
71 (35.5%)
117 (58.5%)
92 (46%)
110 (55%)
93 (46.5%)
83 (41.5%)
129 (64.5%)
83 (41.5%)
The present study was designed to investigate
the distribution of blood groups in IHD in our local
population.
METHODS
The study was carried out at Punjab Institute of
Cardiology, Lahore. Before conducting this research,
approval was taken from ethical committee of
hospital and a written consent was taken from each
participant. A total of 430 samples were collected
and divided into two groups i.e. control (n= 230)
and IHD subjects (n=200). Controls were collected
from current blood donors and individuals having
normal electrocardiogram (ECG).
A questionnaire was filled by each subject
to collect information regarding age, gender,
hypertension, diabetes, family history of ischemic
heart disease, regular exercise, use of ghee or oil for
cooking food, and smoking status. Weight was also
measured with weighing machine in kg. Height was
measured by measuring tape. BMI was calculated
by using the formula:6
BMI = weight (kg) / height (m2)
Blood samples were collected and blood group
was determined by agglutination method using
antisera A, B, and D.Data was analyzed using SPSS
16. Demographic data was presented as Mean ±
SEM. T- test was used for comparison of continuous
variables. Chi-Square (X2) was used for non-discrete
variables. P-value less than 0.05 were taken as
significant.
RESULTS
The control group, which comprised of 230
subjects, includes 167 (72.6%) males and 63 (27.4%)
females. The IHD group consists of 127 (63.5%)
males and 73 (36.5%) females.
Table-III: Prevalence of blood groups
in control and IHD groups.
Sr. Blood Control IHD
No. groups group group
(%) (%)
Percentage
Rh+
1.A
20.9
34
19.1 32 1.8
2
2.B
34.4
29
32.2 24 2.1
5
3.AB 12.6
14
12.6 13.5 -
0.5
4.O
23
28.7 21 3.5
2
32.2
The major risk factors found in our study were
smoking, diabetes, hypertension, sedentary life
style, and the use of ghee for cooking food. They
are suspected to increase the chances for the
development of IHD.
According to the study the distribution of A, B,
AB, O blood groups in the control group were as
follow, 48 (20.9%) had blood group A, 79 (34.3%)
had blood group B, 29 (12.6%) had blood group AB,
and 74 (32.3%) had blood group O. In IHD group,
68 (34%) had blood group A, 58 (29%) had blood
group B, 28 (14%) had blood group AB, and 46
(23%) had blood group O.
The order of percentage of ABO blood groups
among control group was found to be in order
B>O>A>AB and the order of percentage for Rhesus
factor was Rh +ve> Rh –ve. The order of percentage
of ABO blood groups among IHD group was found
to be in order A>B>O>AB and the order of the
percentage for Rhesus factor in patients was Rh
+ve> Rh –ve. It was found that the prevalence of
blood group A was high among IHD group i.e. 34%.
The high percentage of blood group A (p-value <
0.05) shows that there is a strong relation of blood
group A with IHD.
DISCUSSION
In different regions of the world there is specific
ABO blood group distribution. Even in the same
country as in Pakistan minor variations has been
observed.7,8 In Sindh and Baluchistan blood group
O is more common in normal population.9
Table-II: Demographic characteristics of control and IHD group.
Sr. No
Factors
Control
IHD
1
2
3
4
Age (years)
Weight (kg)
Height (m)
BMI (kg/m2)
34.3 ± 0.71
63.5 ± 0.59
1.64 ± 0.06
23.8 ± 0.29
56.4 ± 0.86
69.2 ± 0.87
1.61 ± 0.03
26.4 ± 0.33
*Significant P ≤ 0.05,
594 Pak J Med Sci 2014 Vol. 30 No. 3
** Highly significant P ≤ 0.01
www.pjms.com.pk
Rh-
ControlIHD Control IHD
P value (T – Test)
0.001**
0.001**
0.05*
0.001**
ABO blood group frequency in IHD patients
A significant association was found in Italian
population between blood groups and family
history of IHD and were associated with increased
mortality in patients.10 Anvari showed CABG
patients in Iranian population have high prevalence
of blood group A.11 In a British regional heart study,
7735 men with IHD were examined showing that
blood group A is associated with IHD in middle
aged British men.12
The results of our study showed a significant
association (p-value < 0.05) between IHD and
blood group A. In control group, blood group B had
higher prevalence (34.4%).
Framingham Heart study in 1948 showed that
many different parameters were associated with
the development of IHD. With the development of
modern science certain parameters became recognized as risk factors of IHD.13 Age, sex, family history of IHD and height are non-modifiable risk factors
Smoking, hypertension, diabetes mellitus, obesity
are major modifiable risk factors.14, 15, 16 Obese people are at greater risk to suffer from CVDs.17
This study clearly indicates a high prevalence of
risk factors in IHD group as compared to the control
group. The mean BMI greater in IHD as compared
to control group indicates that majority of IHD
subjects were obese and it can be predicted that
obesity may play an important role in developing
IHD in our local population.
Smoking is the single most important modifiable
risk factor for CVDs and the leading preventable
cause of death.18 Compared with non- smokers, those
who consume 20 or more cigarette daily have twofold
to threefold increase in total coronary heart disease.19
It has been recommended that the constituents of
ghee consist of a probable cause of high CHD risk
among South Asian including Pakistanis.20
The ratio of smoking and use of ghee for cooking
food was found as 58% and 58.5% respectively.
Family history was found to be insignificant in IHD
group with a percentage of 45%.
Conclusion
The results of the present study revealed a
significant association of blood group A with IHD. Risk factors like smoking, age, obesity, use of ghee,
and lack of doing exercise was found to be more
prevalent in IHD group. Thus these might be the
major contributing factors for developing the risk
of IHD in our local population.
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Authors Contributions:
SS: Conceived and designed the protocol of the
project, contributed in writing of the manuscript.
NA: Did data collection, experimental work and
writing of manuscript.
TF: Contributed in writing of manuscript, did
editing and review of manuscript.
SN: Contributed in statistical analysis.
Pak J Med Sci 2014 Vol. 30 No. 3
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